title: Statin exposure is associated with decreased asthma-related emergency department visits and oral corticosteroid use.
abstract: BACKGROUND
  Statins, or HMG-CoA reductase inhibitors, may aid in the treatment of asthma through their pleiotropic antiinflammatory effects.
  
  
  OBJECTIVE
  To examine the effect of statin therapy on asthma-related exacerbations using a large population-based cohort.
  
  
  METHODS
  Statin users aged 31 years or greater with asthma were identified from the Population-Based Effectiveness in Asthma and Lung population, which includes data from five health plans. Statin exposure and asthma exacerbations were assessed over a 24-month observation period. Statin users with a statin medication possession ratio greater than or equal to 80% were matched to non-statin users by age, baseline asthma therapy, site of enrollment, season at baseline, and propensity score, which was calculated based on patient demographics and Deyo-Charlson conditions. Asthma exacerbations were defined as two or more oral corticosteroid dispensings, asthma-related emergency department visits, or asthma-related hospitalizations. The association between statin exposure and each of the three outcome measures was assessed using conditional logistic regression.
  
  
  RESULTS
  Of the 14,566 statin users, 8,349 statin users were matched to a nonuser. After adjusting for Deyo-Charlson conditions that remained unbalanced after matching, among statin users, statin exposure was associated with decreased odds of having asthma-related emergency department visits (odds ratio [OR], 0.64; 95% confidence interval [CI], 0.53-0.77; P < 0.0001) and two or more oral corticosteroid dispensings (OR, 0.90; 95% CI, 0.81-0.99; P = 0.04). There were no differences in asthma-related hospitalizations (OR, 0.91; 95% CI, 0.66-1.24; P = 0.52).
  
  
  CONCLUSIONS
  Among statin users with asthma, statin exposure was associated with decreased odds of asthma-related emergency department visits and oral corticosteroid dispensings.
authors.affiliation: 1 Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.
authors.forename: Sze Man
authors.initials: SM
authors.lastname: Tse
authors.forename: Lingling
authors.initials: L
authors.lastname: Li
authors.forename: Melissa G
authors.initials: MG
authors.lastname: Butler
authors.forename: Vicki
authors.initials: V
authors.lastname: Fung
authors.forename: Elyse O
authors.initials: EO
authors.lastname: Kharbanda
authors.forename: Emma K
authors.initials: EK
authors.lastname: Larkin
authors.forename: William M
authors.initials: WM
authors.lastname: Vollmer
authors.forename: Irina
authors.initials: I
authors.lastname: Miroshnik
authors.forename: Donna
authors.initials: D
authors.lastname: Rusinak
authors.forename: Scott T
authors.initials: ST
authors.lastname: Weiss
authors.forename: Tracy
authors.initials: T
authors.lastname: Lieu
authors.forename: Ann Chen
authors.initials: AC
authors.lastname: Wu
mesh_terms: D000284:Administration, Oral; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D001249:Asthma / Q000150:complications / Q000188:drug therapy*; D016022:Case-Control Studies; D015331:Cohort Studies; D018450:Disease Progression; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D006949:Hyperlipidemias / Q000150:complications / Q000188:drug therapy*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D057216:Propensity Score; D016896:Treatment Outcome
chemical_list: D000305:Adrenal Cortex Hormones; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors